Cardiac antenatal clinic

Pregnancy places a unique stress upon the heart and women with
cardiac disease require specialist advice regarding family
planning, and specialist supervision throughout pregnancy, delivery
and post-partum.

Because of the increasing number of women of child-bearing age
with congenital heart disease (CHD) entering adulthood we now have
increasing numbers of patients with CHD becoming pregnant.
Two-thirds of patients seen in our cardiac antenatal clinic have
CHD and managing the interaction between their often complex hearts
and the changes during pregnancy and childbirth is challenging. We
also see women with acquired heart disease and inherited cardiac
conditions.

The Royal College of Obstetricians and Gynaecologists (RCOG),
European Society of Cardiology (ESC) and Confidential Enquiry into
Maternal and Child Health (CEMACH) recommend that pregnant women
with heart disease are seen in joint clinics, where each patient is
reviewed by a multi-disciplinary team consisting of an
obstetrician, cardiologist, anaesthetist and midwife. In Bristol,
we provide the Gold standard model of care. We see patients from
all over the South West in our all day twice-monthly clinic on the
first and third Fridays of the month in St Michaels Hospital in the
Antenatal Clinic on Level E. Here women can have consultations with
all specialists, midwives, ECG, echo and fetal ultrasound. In
addition, we have a formal monthly meeting where all cases are
discussed. A delivery plan is formulated is then filed in the
mother's delivery notes and on the Central Delivery Suite.